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Robotic vs. Open Surgery

What robotic surgery really involves, and how the right approach gets chosen for you.

Written and reviewed by Carlos Rodriguez, DO, MBA, FACS. Last reviewed October 1, 2026.

The short version

  • Robotic surgery does not mean the robot operates. Dr. Rodriguez controls every instrument from a console in the operating room, and nothing moves unless he moves it.
  • Robotic surgery uses several small incisions. Open surgery uses one larger incision. Recovery after a robotic operation is often quicker, though not always.
  • The approach depends on your anatomy, the size of the problem, your health, and any prior surgery. Heavy scar tissue or a very large hernia can make open surgery the safer choice.
  • Dr. Rodriguez plans every gallbladder removal robotically.

A quick summary. The full details are below, and none of it replaces an exam.

What robotic surgery means

"Robotic surgery" can sound like the robot is doing the operating. It isn't. The robot is an extremely precise extension of the surgeon's hands. Dr. Rodriguez sits at a console next to you in the operating room and controls every instrument movement directly, while the surgical team works at your side the entire time. Nothing moves unless he moves it.

What the robotic platform adds is a high-definition, 3D view of the inside of your body, far steadier and more precise movement than the human hand alone, and the ability to work through several small incisions instead of one large one.

How Dr. Rodriguez decides between robotic and open surgery

The right approach depends on your specific anatomy, the size and complexity of what's being repaired, your overall health, and prior surgical history (scar tissue from a previous operation can change what's safely possible). For most gallbladder and hernia procedures, a robotic approach is often preferred when appropriate, because it tends to mean smaller incisions and a more precise repair. But in certain situations (extensive scarring, very large or complex hernias, or specific anatomic findings during surgery) an open approach is the safer or more effective choice, either from the start or as a planned conversion partway through.

This isn't a one-size-fits-all decision, and it's one Dr. Rodriguez will walk through with you directly during your consultation, based on your imaging, exam, and history.

What's similar either way

  • Same attention to safety steps: critical structures are identified and protected before anything is divided, regardless of approach.
  • Same pain control philosophy: scheduled non-narcotic medications first, narcotics reserved for breakthrough pain.
  • Same follow-up process to check healing and clear you for normal activity.

What's different

  • Incisions: robotic surgery generally uses several small incisions; open surgery uses one larger incision sized to the procedure.
  • Recovery: robotic approaches often (not always) mean a quicker return to normal activity, since the incisions are smaller.
  • Visualization: the robotic camera provides 3D, magnified visualization; open surgery relies on direct vision and feel.
Side by side

Compare the two ways I do it

Pick an operation to see the incisions, the day of surgery, and when each approach fits. Your exam decides which one is right for you.

Inguinal hernia

Robotic

3 incisions, about 1 cm each
  • Incisions in the upper abdomen, not over the hernia
  • Mesh goes in from the inside, and the lining is closed over it
  • Most patients go home the same day
  • Recovery is generally quicker than open repair
Robotic inguinal repair →

Open

1 incision, about 10 cm
  • One incision just above the groin crease
  • Mesh on the floor of the canal, under the cord
  • Most patients go home the same day
  • The right choice for patients not suited to a robotic repair
Open inguinal repair →

Umbilical hernia

Robotic

4 small incisions, to the side
  • Mesh with wide overlap, placed from the inside
  • About an hour in the operating room
  • For hernias over 2 cm, or with risk factors such as higher weight, smoking or diabetes
  • Most patients go home the same day
Robotic umbilical repair →

Open

1 small curved incision under the belly button
  • Stitches alone for many hernias 2 cm or smaller
  • About 30 minutes in the operating room
  • Mesh added for larger or recurrent hernias
  • Most patients go home the same day
Open umbilical repair →

Gallbladder

Robotic

Usually 4 small incisions
  • A 3D, magnified view through small incisions
  • Most patients go home the same day
  • Most return to work in 1 to 2 weeks
Gallbladder removal →

Laparoscopic or open

I plan every gallbladder removal robotically, and I have not planned a laparoscopic one since 2022.

Why I made that choice →
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